A Pain Management Programme (PMP) to give people with chronic pain, including chronic back pain and Fibromyalgia Syndrome, the tools to manage their symptoms has been piloted by the Bay Health and Care Partners (BHCP).
PMP is supported by the pain management and physiotherapy services at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), Lancashire and South Cumbria NHS Foundation Trust (LSCft), local GPs and the Integrated Care Communities.
PMP offers people advice on:
- understanding pain
- pacing and activity
- looking at lifestyle factors that affect pain including stress, diet and sleep
- breathing and relaxation techniques
- reconditioning exercises
- understanding flare-ups
- psychological support to manage pain.
The aim of PMP is to provide greater support in the community for people with chronic pain to reduce the need for them to attend hospital and attend GP appointments. The Royal Lancaster Infirmary (RLI) and Furness General Hospital (FGH) see around 400 patients with fibromyalgia every year and between January and May 2019, there were more than 100 non-referrals and patients admitted to the RLI and FGH with acute back pain.
The pilot sessions took place at Castle Street Community Centre, Kendal, before the tier restrictions/local lockdowns were brought in by the government. They were held over four weeks with a small group of two patients (following the government’s guidance on distancing for COVID-19).
Pat Newton, of Kendal, attended the PMP sessions. She suffers from severe back pain due to severe spinal stenosis (a narrowing of a section of the spinal column, which puts pressure on the nerves inside) which she was diagnosed with six years ago.
Pat said: “I would definitely recommend these sessions to others who are suffering from severe pain. I feel like the sessions have given me more confidence to do daily tasks and to think more about how I can manage my condition.”
BHCP hopes to continue the sessions next year, running them alongside a 1-1 self-management programme which has seen 26 people suffering from chronic back pain, fibromyalgia and complex regional pain syndrome over the past 18 months.
The pilot PMP session included a talk from Mark Mellar who suffers from chronic pain of the leg following a serious motorbike accident in February 2015. Mark has attended the 1-1 self-management programme for his pain.
Zoe Hamilton, Extended Scope Practitioner Physiotherapist, UHMBT, said: “It’s really nice for patients with pain to meet others who are going through similar circumstances and clinicians who understand chronic pain as it can be a very lonely place for them – group sessions can ease anxiety, provide a social space and aid learning from each other.
“It’s really important to try and reduce the fear associated with exercise and movement that many patients have. We encourage them to pace activity so they can learn to perform tasks in a controlled way so that it doesn’t exacerbate their symptoms and pain.
PMP also shows patients how to recondition themselves and strengthen muscles they may have not used for a long time to make tasks easier to perform. A lot of people with pain can hold themselves tensely and forget how to relax – at the sessions we show them a variety of relaxation and breathing techniques to help this.”
Keith Jamieson, Cognitive Behavioural Psychotherapist for First Step, Lancashire and South Cumbria NHS Foundation Trust (LSCft), said: “We were very pleased to be asked to contribute to the Pain Management Plan pilot led by the UHMBT Pain Management Team. First Step practitioners worked in partnership with the Pain Management Team to deliver the programme to patients during the pilot. The Cognitive Behavioural Psychotherapists from LSCft First Step South Cumbria delivered the psychological aspects of the programme integrating Cognitive Behaviour Therapy into the pain management programme, with the goal of the patients being able to self-manage their long term pain. We are looking forward to continued collaborative working when the COVID-19 restrictions will allow this to continue.”
Pam Brier, Pain Management Practitioner, UHMBT, said: “The aims of both our group PMP and 1-1 self-management sessions are to offer alternative methods to those of traditional chronic pain management treatments such as injection therapy and analgesia, by providing patients with the right self-care tools to manage their pain effectively. This includes lifestyle changes, education, activities and thinking about their pain and how they can manage it better.
“Through PMP the Bay Health and Care Partners are offering a multi-disciplinary approach where patients are receiving medical, physiological and physical support all in one place. By providing these sessions in the community we are reducing unnecessary GP and hospital appointments for many patients (who don’t have other underlying health issues or who need further investigations).”
John Butterworth, Integrated Care Manager, UHMBT, added: “It’s a credit to the participants and the clinical teams that we’ve managed to bring everyone together and deliver this programme in these challenging times.
“We’ve already had interest from GP practices and we’re now planning regular sessions following the success of the pilot.”